The nurse is caring for a patient who professes to being an agnostic. Which information should the nurse consider when planning care for this patient’s belief system?

Choice A reason: While hospice provides pain management, this is not the primary criterion. Many patients receive pain management outside hospice. The defining factor is a prognosis of less than 6 months, making this choice incomplete and less accurate for explaining hospice eligibility.

Choice B reason: Having a terminal illness like cancer is relevant, but not all terminal patients qualify for hospice. The key criterion is a life expectancy of 6 months or less, as determined by a physician. This choice is too broad and lacks specificity, making it incorrect.

Choice C reason: An advance directive is not required for hospice eligibility, though it may guide care decisions. Hospice focuses on prognosis, not legal documentation. This criterion is irrelevant to qualifying for hospice services, making it an incorrect choice for the nurse to share.

Choice D reason: Hospice care is for patients with a prognosis of 6 months or less, as certified by a physician. This criterion, per Medicare and hospice guidelines, defines eligibility for terminal cancer patients, ensuring comprehensive end-of-life care. This is the most accurate information for the nurse to share.

Choice A reason: Asking if the patient is reliving trauma targets a core PTSD symptom—intrusive memories or flashbacks—critical for diagnosis per DSM-5 criteria. This question helps identify PTSD’s psychological impact, guiding interventions like cognitive behavioral therapy or SSRIs. Prioritizing this ensures timely recognition of PTSD, addressing the patient’s sleep disturbances and trauma-related distress effectively.

Choice B reason: Asking when the patient wakes up provides limited insight into PTSD. While sleep timing may indicate disturbances, it doesn’t address specific PTSD symptoms like intrusive memories or hyperarousal. This question is less urgent, risking delayed identification of PTSD, which requires targeted psychological assessment to guide therapy and medication for trauma-related nightmares.

Choice C reason: Describing phobias is irrelevant to PTSD assessment, as phobias are distinct anxiety disorders. PTSD involves trauma-specific symptoms like flashbacks, not generalized fears. This question misdirects focus from trauma-related sleep issues, potentially delaying PTSD diagnosis and appropriate interventions like trauma-focused therapy, leaving the patient’s nightmares and distress unaddressed.

Choice D reason: Asking about chest pain assesses physical symptoms unrelated to PTSD’s psychological profile, which includes nightmares and intrusive thoughts. While chest pain could indicate anxiety or cardiac issues, it’s not a priority for suspected PTSD. This question risks overlooking trauma-related symptoms, delaying psychological evaluation and support critical for the patient’s mental health recovery.